It’s a complicated web we weave

Ever notice that in life sometimes things fall together in an uncanny way? It may be interpreted as divine intervention, or fate, or some people may just figure they have it all figured out. I like to see it as a sign that you are on the right track in whatever you are doing. I feel that when you follow your instincts and pursue what is right for YOU, things start to fall into place.

An example is what is happening in my residency lately. The idea of my residency is to improve continuity of care in healthcare for the people of Maui. Being an island, we are a rural population as a whole. Maui has only one hospital, so as far as our population, we have the perfect opportunity to better the overall continuum of care on Maui and to document and track our results as well. Unfortunately, the hospital half of our residency backed out, so we are not able to complete the circle. On the positive side, it is forcing us to seek out other ways of increasing our involvement in the community in order to reach the same goal.

It might have started when we were doing MTM, and I contacted the folks at Hale Makua, a long-term care/rehab facility about some patients. I spoke with the pharmacist who consults there and decided that it would be good to do a rotation with them. That is still in the works, but next I found the Medical Reserve Corps (MRC), for which Sheena and I signed up. We had been looking at ways to meet all of our Outcomes, Goals and Objectives of the residency, and the MRC will certainly help with that. I decided to cast the net further. One day about 3-4 weeks ago, I woke up at 5am to watch a webinar. Yes, it is 5 hours earlier than EST here, so sometimes a webinar will fall at 3am. We prefer the later ones, obviously. Turns out this webinar was about the PSPC (Patient Safety and Clinical Pharmacy Services Collaborative), a HRSA funded initiative. In their words, ‘The Patient Safety and Clinical Pharmacy Services Collaborative (PSPC) is a breakthrough effort to improve the quality of health care across America by integrating evidence-based clinical pharmacy services into the care and management of high-risk, high-cost, complex patients.’ It turns out that one of the programs they highlighted in the webinar was the New Mexico PSPC, and they quoted one of my prior pharmacy professors, Dr. Krista Salazar. That got me to thinking about how we could get something started here, or at least lay the foundation for the incoming residents. I let everyone know about it, but nothing has been done quite yet.

Sheena had also been looking for opportunities, and she found the Maui Rural Health Outreach program website, which was defunct. When she contacted them, she found out that the program was no longer active, but that the contact person was affiliated with the Aging With Aloha Coalition. They contacted Sheena and invited us to present to them next week at one of their monthly leadership team meetings. We have 20 minutes to wow them.

‘I am a PGY1 Community Pharmacy Resident working for the University of Hawai’i at Hilo College of Pharmacy in the rural communities of Maui County. Federal funds support my year-long program, and I am helping to better the health of a rural population. Unfortunately, due to current legislation, I must put my loans into forbearance. In order to pay off these loans, I will need to take a high-paying job which most likely does not serve the population I am devoting this entire year of service to. In order to retain healthcare providers like myself who are dedicated to increasing the quality of care in these populations, it is crucial to provide us the same opportunities for loan repayment as the other healthcare professions. This applies not only to the NHSC loan repayment program, but also to loan deferment, which pharmacists also do not qualify for. The financial barriers to having pharmacists in rural areas are numerous and perpetuate the lack of continuity of care in the current healthcare system of America.’

Not a minute after sending the email, I receive an email regarding the Aging With Aloha conference in April. The tentative conference program had as it’s first discussion, the National Health Service Corps loan repayment for Psychologists, Dentists, Dental Hygiene, SW, NP, PA, docs (notice pharmacists are not included in there). WHAT TIMING!! Not only that, but we saw that among the invitees is our very own Karen Pellegrin from the UHH College of Pharmacy.

I truly feel like we are finally finding our way into the community and might actually find that niche that we so need to fill.